title: Unusual clinical course of preeclampsia heralded by generalized edema.
abstract: Preeclampsia monitored by the amount of proteinuria usually does not show amelioration during pregnancy. A 37-year-old nulliparous woman was admitted to our hospital at gestational week (GW) 24(-1/7) due to rapid weight gain (6.2 kg/4 weeks) and oligohydramnios. Hypertension (151/91 mmHg) appeared at GW 25(-0/7) and proteinuria not detected at GW 24(-0/7) became significant (0.55 g/day) at GW 25(-2/7) . During the 2 successive weeks after administration of betamethasone at 12 mg twice and transabdominal amnioinfusion with 250 mL of Ringer's acetate solution at GW 25(-3/7) , generalized edema, proteinuria and thrombocytopenia markedly improved: bodyweight, 78.0 to 69.0 kg; proteinuria, from 7.1 to 1.3 g/day; and platelet count, from 111 to 230 × 10(9) /L. However, intrauterine infection accompanied by non-reassuring fetal status necessitated emergency cesarean section at GW 28(-3/7) . Extraordinary bodyweight gain can herald the occurrence of preeclampsia and this weight gain together with signs of preeclampsia can ameliorate even during pregnancy, although its mechanism is unclear.
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kojima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Cho
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D004487:Edema / Q000209:etiology*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia; D011247:Pregnancy; D012075:Remission, Spontaneous
keywords: gestational edema; preeclampsia; thrombocytopenia; vascular permeability